Topic Overview

A number of things influence how much milk you produce (your milk supply). The two most important things are how often you breast-feed and how well your breast is emptied. The hormone that regulates milk production (prolactin) is stimulated by breast-feeding. So the more frequently you feed your baby and empty your breasts, the more milk your body produces.

Breast milk changes over time with a baby's nutritional needs. The first milk produced is colostrum, a sticky, yellowish liquid that contains protein, minerals, vitamins, and antibodies. Colostrum is produced during pregnancy and the first few days after delivery. The transitional milk comes in after the colostrum, followed by mature milk about 10 to 15 days after you deliver your baby.

Building your milk supply

Follow these tips to help build and maintain your milk supply:

• Breast-feed more often. Feed your baby on demand, which means whenever he or she wants to eat. Newborns need to breast-feed about 8 to 12 times in a 24-hour period. Wake your newborn if it has been more than 2 hours since the last feeding. During growth spurts, your baby may seem very hungry. More frequent feedings will increase your milk supply, usually within 2 to 4 days.
• Breast-feed for a longer period at each feeding.
• Feed on one breast until it is empty, before changing to the other side.
• Help your baby latch on properly. View a slideshow on latching to learn how to get your baby to latch on.
• Improve your let-down reflex by staying comfortable and relaxed at each feeding.
• Avoid tobacco, excessive caffeine (more than 3 caffeinated drinks a day), and certain medicines. If you plan to take birth control pills, talk to your health professional to find out when you can start.
• Avoid bottle-feeding your baby (with breast milk or formula) until breast-feeding and your milk supply are well established.
• Get enough rest, drink plenty of water, and eat a balanced diet.

Low milk supply

Many women are concerned that they are not producing enough milk. True milk insufficiency, or low milk supply, is rare. But it takes time to establish your milk supply. If you've tried feeding your baby more often and you still don't think your baby is getting enough milk, talk to your doctor or lactation consultant. He or she can help you determine whether you have a problem with your milk supply and help you solve it.

Cautions about alternative remedies for low milk supply

Some women are advised to try herbal remedies to increase milk supply, such as fenugreek, fennel, or various herbal teas. But do not use any of these remedies without first consulting your health professional. The effect of herbal remedies on milk supply has not been well studied. Some medicines are available that may help increase a woman's milk supply. Talk to your doctor if you are worried about your milk supply.

Although domperidone is available in some countries to treat gastric disorders, it is a medicine that is not approved for any use in the United States. Still, some breast-feeding women obtain this medicine and take it to increase their milk supply. This medicine increases milk supply by stimulating the production of the hormone prolactin. The U.S. Food and Drug Administration (FDA) has issued warnings for breast-feeding women to not take domperidone because of its potential dangerous side effects (such as irregular heartbeat and sudden death). Also, the drug has unknown effects on the breast-feeding infant.¹